Field Theory in Child and Adolescent Psychoanalysis

Understanding and Reacting to Unexpected Developments

Elena Molinari

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781134875580
• Edition: 1
• Topic: Psychology
• Subtopic: Psychoanalysis
• Index: Psychology

Field Theory in Child and Adolescent Psychoanalysis looks at the intersection of two types of psychoanalysis that challenge the classic model; child analysis, and field theory.

Children impose a faster pace on the analysis and a much less stable structure than adults, whilst psychoanalytic field theory looks at the patient-analyst relationship in a much wider context than is typical. By combining these two approaches, this book advocates the use of a set of tools and techniques that allow the psychoanalyst to understand and react much faster than normal, and to be better prepared for unexpected developments. This book shows the reader how to navigate smoothly and steadily through passages of tense analytical situations, which might otherwise feel like being trapped in a maze with no obvious way out.

Bion's writings allowed the improvement of new techniques or instruments for exploring the psychoanalytical process. Discussion about technique is a hugely important and necessary step for improving the evidence base of psychoanalytic psychotherapy. This book also seeks to improve the research in therapeutic effectiveness and unexpected relationsbetween body and mind, emotions and dreams. By doing so, Elena Molinari contributes to expanding the perspectives that child and adolescent psychoanalysts have had in exploring primitive functioning of the mind.

With specific emphasis on working with difficult situations and patients, Field Theory in Child and Adolescent Psychoanalysis is a highly practical book that will appeal greatly to child psychoanalysts and psychoanalytic psychotherapists, as well as psychologists, paediatricians and advanced students studying across these fields.

Chapter 1

From one room to the other

A story of contamination – the relationship between child and adult analysis

The room had its passions and rages and envies and sorrows coming over it and clouding it, like a human being.

Virginia Woolf¹

The door to my office opens onto a small waiting room: to the left an ordinary glass door leads to the consulting room for adult patients; to the right a sliding door with stained-glass windows gives way to the consulting room for children. On countless occasions, passing from one room to the other over the course of a day’s work, I would allow the reflection of the coloured glass to appear and disappear on the wall without thinking too deeply about which features were common to the work that took place in these two separate spaces and which were particular to each.

For a long time, I was satisfied with the idea that in both rooms I was attempting to practise psychoanalysis and that the difference in what took place in the two rooms was based on a divergence in technique and language. One day, however, as I opened the coloured door leading to the children’s room, designed in the style of a Mondrian painting, I realized that my love of painting and psychoanalysis met at a point within myself. It seemed to me as if in one room there was a type of psychoanalysis which resembled literature and in the other a type of psychoanalysis which resembled visual art. Upon further reflection, I was surprised to discover that, within the sphere of the theoretical model that underpinned my analytical practice, certain events that had taken place in the children’s room had silently modified the implicit theoretical model which I used in my work with adults. This chapter is an attempt to define the particular features of child analysis and to share my experience of the transformative role which the practice of child analysis can have on one’s work with adults.

A historically difficult relationship

The aim of psychoanalysis is not to create an artistic product but is in fact the process through which one carries out analytic work; this “is not unlike the complex, tormented, and exhilarating gestation of a work of art”.² The idea that child analysis is closer to painting and adult analysis to literature came to me through reading Virginia Woolf’s diaries and her correspondence with her sister, Vanessa Bell. These two women competed with each other using two different forms of expression – literature and painting – and engaged in an intense dialogue, provoking and inspiring a reciprocal investigation of each other. I cite here a few extracts from this correspondence to illustrate how the relationship between child and adult analysis has historically played out. “Surely you must see the infinite superiority of the language to the paint?” wrote Virginia Woolf to her nephew in 1928.³ The author here captures the sense of privilege which the word has enjoyed in Western culture: a tradition of thought which has treated first logos and then the word as the privileged vehicle for communication.

Scant interest has typically been shown for images when they are in a direct relationship with a text, serving the function of illustrating it. They are merely regarded as useful as an aid to comprehension and as a way of making the words more appetizing. The relationship between word and image became a source of bitter conflict between the two sisters when Vanessa attempted to illustrate some of Virginia’s writings in a way that broke with the traditional understanding of illustration. She not only did not illustrate the contents but also ended up decorating the page in such a way as to obscure some of the written text. This episode may be compared, albeit with some caution, to the first steps of child psychoanalysis.

Freud’s position rested on the idea that child analysis could not satisfy what was then deemed indispensable for performing analytical therapy: a sufficiently developed ego and the presence of a repressed trauma which could be cured by being re-experienced in the transference of neurosis. It is for this reason that Freud regarded child analysis as an application of the principles of psychoanalysis to pedagogy, a useful instrument for testing the hypotheses about child development that he formulated by induction through his adult patients’ memories.⁴ By contrast, Melanie Klein⁵ maintained the existence of a primitive ego capable of producing phantasies within the first months of life, thus detaching the unconscious phantasy from the mechanism of repression which made such phantasy possible only later, at the twilight of the Oedipus complex. With Susan Isaacs’s contribution,⁶ the unconscious phantasy assumed in those years an ever more central position in the analytic process, eventually coinciding with the unconscious activity present from birth. This progressive theorization of a highly primitive unconscious phantasy entailed overthrowing the historical paradigm of reconstruction and paved the way for the development of the idea that the unconscious phantasy, encouraged by the encounter with the analyst, is what gives life to any gesture or narrative in the consulting room. Unconscious phantasies, like dreams and oneiric thought more generally, make use of a primarily iconic code for which both Melanie Klein and Vanessa Bell claimed an autonomous communicative power. At a conference at Leighton Park School, Vanessa Bell articulated the foundational principle of her aesthetic by affirming that, while novelists claim to depict reality, they do not really see it but observe it by describing its details. On the contrary, it is the painters who succeed in depicting reality, since their main concern is the study of colour in relation to the form of objects and the space surrounding them.⁷

From the same perspective, one can argue that child psychoanalysis has not turned out to be, as Freud thought, an application of adult analysis but the catalyst for Bion’s epistemological revolution. Indeed, in spite of never having worked with children, Bion integrated into his thought the insights yielded by child analysis into the origins of thinking and the earliest forms of mental activity, building upon these premises a theory different from the one based on the instinctual model.⁸ Now that the debate, with its roots in these theoretical differences, has become amicable in nature, allowing for a dialogue between the pulsional model and that of the development of thinking, I would like to show how the two arts – of child and adult psychoanalysis – continue to influence and stimulate each other in clinical work.

Following Bion, some authors maintain that there is no difference in the development of oneiric thought in waking life taking place during analytic sessions. To use Bionian terms, the α function – that is, the mental function that consents to the transformation of the β elements (proto-emotions and proto-sensations) into visual pictograms – works in the same way, irrespective of whether an analyst uses actual play or the account of play. These authors thus maintain that it is possible and useful for the analyst to translate a session from the language of children into that of adults. This is tantamount to demonstrating that the same scene can be described and illustrated using two different languages without bringing about substantial differences in the analytic process. In keeping with this line of thought, since the two practices are mutually reinforcing, child analysis can refine the analyst’s sensitivity to forms of expression other than words. While sharing these ideas, the debate between Vanessa Bell and Virginia Woolf has led me to ask the following question: although I may make use of the same theoretical model, do I really perform similar mental operations in the children’s and adults’ consulting rooms?

In the children’s consulting room

Reflecting on my experience, I feel I am a different psychoanalyst in the two consulting rooms in several respects. A first way of describing this sensation is to say that, when I work with children, I think less. When I am with children, I immerse myself in practical activities and in a series of actions which constitute play in such a way as to carry me further away from reflective thought than is the case in my adult practice. In a sense, child analysis is an experience in which Bion’s recommendation that the psychoanalyst “abandons memory and desire (in order to be optimally intuitive and receptive to his own unconscious vis-a-vis the analysand)”⁹ comes naturally. The shift away from theory, induced by action, produces a distance from reflective thought and from what can be experienced as cluttering the mind.

A second difference becomes apparent when writing notes after a session. One finds oneself organizing the content of a session of adult or child analysis in a logical and systematic way that does not reflect the reality. One tends to organize the analytical interaction in such a way as to omit what one has not understood or what one’s consciousness has failed to translate into words. When writing up notes on a session of child analysis, I have a far greater sense of the presence of inexpressible fragments, whether in terms of the sequence of the play or in the meaning of the narrative. Accompanying this is the sensation of having incorporated many images into a process which comes close to a kind of slow assimilation, until I feel as though the images have become my own. I have suggested that the faster rhythm of one’s interaction with children is in a way counterbalanced by the slower rhythm of one’s elaboration. The child induces the analyst to take longer over the rhythmic and sensory structure of the interaction: the mind requires more time to move from this type of interaction to symbolization, however we wish to understand it. The resulting idea is that of a loss of control over the progress of symbolic transformation, an idea that is masked by a vague sense of unease.

When working with children, I am inclined to represent emotions in a more figurative and pictorial form, with the result that I risk ending up in a silent internal space where the idea of a cure comes closer to a sense of moving together towards the production of symbolic forms.

The analytic game

The suspension of action has been one of the fundamentals of the analytic method so that even in child analysis the analyst is limited to accompanying or interpreting the child’s games with words. Kleinian analysts in particular have theorized about the importance of the analyst’s remaining outside the play in order to understand its meaning.¹⁰ Whereas for these analysts the aesthetic sphere of playing – by contrast with the rational sphere – was considered to be of little use for knowing and understanding things in an analytical way, for Winnicott, playing became not only a means to represent the unconscious but also a vehicle for conveying different meanings. Playing became for Winnicott a category for what was possible, placing both the psychoanalyst and the child in the moment at which things begin to take shape. Almost like a kind of arising logos, during the generative moment, playing manages to take the analytic couple towards a form of representation similar to that of Chinese poetry. Here, most of the ideographical roots preserve in themselves a verbal idea of action, and the thing, which remains indistinct from action, includes its movement in a dynamic framework. Moreover, all subjects of analysis, initially performing actions, engage in a dialogue with what concerns them, until these actions become significant, receiving meaning not from an external attribution but from the same conscious and unconscious action that generates them.

Taking this idea to its extreme conclusion, Winnicott overturns the system of references by making playing, previously just an instrument in the psychoanalytic process, the foundational element of analysis. Indeed, he goes so far as to define the psychoanalytic process as “a highly specialized form of playing in the service of communication with oneself and others”.¹¹

Having expanded our theoretical horizons, Winnicott is also the catalyst for important shifts in the theory of technique. When describing his way of interacting with children through squiggles, Winnicott¹² comes across as an analyst capable of actively participating in the creation of graphic representations and, at the same time, willing actively to reveal something about himself in relation to the process as it occurs.

After Winnicott, it was above all the object-relations analysts who took up some of the ideas just discussed and theorized about the need for the child analyst to be entirely immersed in the metaphor of play so as to actively participate in the creation of possible meanings. Many analysts today share the notion that playing is a therapeutic process in itself and not a process in the activation of other therapeutic processes.¹³ Moreover, the interpersonal relationship, with its many moments of real contact and separation, finds in Winnicott’s account of playing a physical representation of the ruptures and healing capacities that a child experiences in relation to the mother. These aspects of playing have been greatly enriched by observing the role of the bonding of mother and child in the development of the capacity to work through emotions and develop healthy relationships.¹⁴

As an instrument for the development of various possible stories, playing is in the end an essential instrument for analysts who privilege as the goal of analysis the expansion of the bi-personal field and the development of the mental container of both members of the analytic couple.¹⁵ One technical implication of the theoretical developments briefly summarized earlier is that verbal interpretation has become less important for child analysis than for adult analysis. At times, this kind of interpretation can even risk becoming harmful if it interrupts the natural process by which the child comes to make the distinction between phantasy and reality through the expansion of the phantasy itself.¹⁶ I will now attempt to answer the question with which I began: is there a difference between the physical playing which is practised in the child’s consulting room and the primarily verbal one which characterizes analytical work with adults?

The body and playing in relation to reverie

My hypothesis about how children’s play could produce specific processes is derived from Marion Milner’s reflection on the creative process in drawing. Milner believes that, in order to draw, two mental functions are necessary: a reflective function and the capacity to abandon oneself to the unconscious. If one pays excessive attention to one’s original intentions, then the drawing will turn out to be rigid and ...

Table of contents

• Cover
• Title
• Copyright
• Dedication
• Contents
• List of figures
• Acknowledgements
• 1 From one room to the other: a story of contamination – the relationship between child and adult analysis
• 2 Luigi and the cinématographe, the first motion-picture camera
• 3 An analyst learns to play: from crumpled-up paper to origami
• 4 A ‘quantum’ of truth in a field of lies: the investigation of emotional truth in a child analysis
• 5 The anteroom: a camera obscura for grasping aspects that are invisible in the classical setting
• 6 The use of child drawings to explore the dual  group analytic field in child analysis
• 7 Sunday cartoons and very young patients
• 8 Action across emptiness
• Bibliography
• Index